through us or your cvos and we can slot that person into the appropriate housing opportunity when they're available. so with that the next two are under our aging adult services program so i'll give anne hinton director of dos opportunity to talk about those two. >> good afternoon, supervisors. i actually thought i would take a minute and draw your attention back to page 5 and the slide that trent was referencing, the adult services department at 1.73.6 million. and just to say that we're divided into four divisions, trent mentioned ihss program which serves about 20,000 san franciscans but we also then, a second part of our department is the protective services, which is adult protective services, the public guardian, pa, and so on. we also are -- house the older americans act programs under the agency on aging and veterans

services. so that's a third division. the fourth is long-term care services and support and that primarily relates to transitional care, the community living fund and division and community integration programs. so then taking you back to slide seven and those last two items, so try to connect the dots a little here. the ihss memo of effort, this is part of governor brown's coordinated care initiative, which is part of an opportunity that the state had under the affordable care act to begin to move people -- older adults and younger adults with disabilities into managed care. part of that will not happen for a number of years. but the good thing for us is that the maintenance of effort that has been drawn up between the states and the county is actually going to have a financial benefit to san francisco. and so we're -- so the positions that we are proposing are revenue-backed by those revenues

that are coming to us that are part of this maintenance of effort agreement. the last item on this slide is the broadbent technology opportunity. i think most of you are aware of the technology centers that are available in your different districts for older adults and younger adults with disabilities. we have placed over 200 computers in centers. there's been something like 40,000 hours of training done. almost 21,000 folks who have been trained. and so the initiative that we have -- in this year's budget really is to keep these last three years of work that we've done in the various communities alive and moving it forward. we have older adults and younger adults with disabilities now accessing medical records, being able to talk with grandchildren and people around the country and around the world. and it's certainly has shut down that myth when you're older you can't learn new things. we're very proud of this work and think that this initiative

is well worth the support. thank you. >> chair farrell: thank you very much. >> supervisors, the rest of the presentation you have, i'm happy to go through it but it's pretty detailed. so supervisor farrell and i, in talking yesterday, felt that you can take a look and if you have questions obviously, speak with me. or if the committee would like, i can certainly go through them. >> chair farrell: thanks. supervisor wiener. >> supervisor wiener: thank you. thanks for the presentation. just a question. you went over this i think briefly before. but the 102.3 million in homeless services, can you break down what goes into that. because when you always hear different numbers about how much we're spending on homelessness, 100 million, 200 million. i know there are a lot of -- it interconnects with a lot of different services so i know it's probably pretty challenging. of course once we house a

homeless person they're not homeless anymore depending on what kind of housing it is. so i'm curious to know. >> thanks for it the question, supervisor. here it is. so broadly speaking, what the 102 million, as proposed funds is our emergency shelter system for single adults which is about 10 million -- i'm going to ballpark it because i don't have the details in front of me -- our family shelter system is, our family shelter waiting list, transitional housing for families, and then a huge portfolio of supporting housing for single adults which is now about 3200 units. that's the bulk of it. when i say funding supportive housing, what does that mean. it means subsidizing the tenants rent, it means paying fr property management, it means paying the least cost to the owner but that's the form of the subsidy to the client and paying for services on site. ta's in the that's in the form

of case managers, mental health support, substance abuse support. it gets expensive. but it's as expensive or more expensive to have that same person be on the street, utilizing emergency rooms, crisis clinics, ems calls, police, studies have shown that. we've talked, supervisor, about sort of where we're at now with our approach to homelessness. you know, we were very i think successful over the last many years at implementing what we call housing first, which was based on a lot of research and studies that show that anyone can be housed. the notion that someone had to be housing-ready was turned on its head about eight years ago. so we did a really good job of putting housing first forward and getting folks, who have multiple barriers, into that housing. but that's what we focused on is housing first.

the success was defined keeping that person in housing. housing retention rates over 90% for a difficult population is laudable. however we're at the next phase where we built up our portfolio but not seeing a lot of turnover. we're not seeing a lot of turnover because our goal is to keep folks in housing. i think it's probably time to look at what our next phase is, and what that looks like to start to generate more positive exits from our housing for folks, whether through employment, through connection with individuals families or friends, through getting on disability assistance where we can raise someone's income. so thinking through what that might look like in our buildings and we have 30 plus buildings, and what that staffing mix and investment might look like. that's something we're discussing internally now. >> chair farrell: in terms of those 3200 units is there a formal waiting list in terms of knowing what the the backlog of people who want to go into that

housing, and but who are -- there's not a unit available. >> unlike the housing authority our buildings don't have a wait list. what we've developed are access points, an access point being the shelter, streets, general hospital, other sort of points of contact with our system. and they get referred into whether it's us for placement at our housing or dpa for dos housing, criteria are used such as acuity levels of individuals, are they very sick, do they really need to be housed, prioritizing in that way. we look at time in shelter. if they've been in shelter for a long time they would be prioritized. i can tell you the wait out of shelter, of someone who is in the queue, they're in our shelter system consistently the wait has been generally four months to get into housing. our turnover is about 20 to 30

units a month. >> supervisor wiener: the 20 or 30 units a month that become vacant and available, what -- i imagine there are various reasons why they become vacant. can you sort of -- and i'm particularly interested to know, in terms of people successfully moving back, say potentially into the job market or being able to have housing of a different kind of housing, and then open up such spot so someone else can come off from a shelter. >> right. so we've worked a little bit with the controller, two years ago, maybe a year and a half, on sort of examining kind of those questions, what are the rates of turnover, what are the lengths of stays, what are the reasons for turnover. one of the things we found data at the provider level was not very robust. an hanecdotally of our exits, hf

or so may be considered positive and the other half not, meaning evictions for failure to pay rent, for not allowing unit inspections, a range of reasons. we try not to evict but sometimes you need to or the quality of life in the building gets degraded. but other exits are folks do get a job and they move. folks get reunited with their family and leave the city, those kinds of better exits. what we're again sort of through this process of thinking through in a sophisticated way what the next phase looks like those are questions what needs to answer and what works internally towards doing that and moving towards a pilot, either an existing building or new building, a pilot of what a more transitional model looks like. not transitional housing because that's a forced exit after a certain period of time. but a service mix that with the

intent of it being a transitional housing placement, you know, and seeing what that might look like, who might be the candidate to enter that type of program, could it be anybody, would it be folks from homeward bound. those questions we would answer through data and maybe piloting something. >> supervisor wiener: do we have -- and i know there -- this flows into dph at some time. i know not all of the services or contacts with the homeless are through hsa. do we have data on people who are living on the streets, in it terms of what perge percentage of them are actively trying to get into shelter, other forms of housing. and what percentage report. i know there's a debate about whether there are or aren't enough shelter beds, whether people are on the streets simply because there is no bed for them

as opposed to people either choosing to be on the street, or because of mental illness or drug addiction, liking the capacity to really enter into the system. do we have good data on that bakedown? >> you know we really don't but all the things you mentioned are reasons folks are on the street, whether it's inability to access a bed on a given night, whether it's the shelter system as it is now isn't good at accommodating an individual, whether the person doesn't want to have lights out at 10:00, or not be able to use indoors, that sort of thing. whether it's not understanding the shelter system, if they're new to the city. whether it's mental illness and substance abuse, addiction preventing them to think rationally. all that stuff is mixed in. as part of our homeless count this year we surveyed over 1,000 folks on the street and it was a

robust survey so we hope to glean more about things like how long have people been on the street, where they came from, why are they not using shelter, have they used shelter in the past, to answer some of these questions. >> supervisor wiener: you know, i think it's -- and this is the frustration throughout the city because we have this -- you know, for decades now, really significant challenge around homelessness. and we spend -- it's $102 million for the programs u described. when you add dph and everything else in there it's significant higher. so we're spending a lot of money, and, you know, i'm a believer in having a policy in it budget discussions based on data. and where it's possible to have that data, so we can make good policy decisions about how we're allocating our resources, and whether we're succeeding, and whether it's a good expenditure,

is there a better way to expend it to address the challenge. and it seems like having more thorough data about what we just talked about in terms of why people are on the street versus in a shelter, or in housing, knowing what the breakdown is, and also data about the people who are currently housed, and why they're leaving would be important. because i compoa in working with various segments with our homeless provider network there are some really amazing people in city staff, and in nonprofits, and amazing organizations, who a lot of people who do tremendous work, but i think in terms of the broad structure it would be really good to have a deeper understanding of that information, that data. >> you know i think we're on the same page, supervisor. one of the things i talk about is i think our system is really

effective at solving the homeless problem on the individual level. we know how to do that. we know that supportive housing works. we know that we have great outcomes in supportive housing. we're a national model. but then we go bigger and systematically and you see we still have a couple thousand people on the street, we still have 260 families on the homeless family waiting list for shelter. answering those questions as to why, you know, how can we house or reunite someone with their family through homeward bound, over 14,000 people since 2004, yet you can argue you haven't seen appreciable improvement on the street. i would argue that we have but some argue that we don't. you know, those are the big questions. you know, influx of people, influx more than outflow, you know, all urban centers, you know, claim to be sort of attracting the hoamsdz. homeland homeless.

i think that's right. it's the urban areas. it is about getting smarter, about who is on the street, who's in need and why the system that's effective for so many thousands of people not effective for that person on the street. >> supervisor wiener: do we have estimates for how many people per year are arriving in san francisco and are immediately homeless? >> no, we don't. what we will have, from the survey, and we've done this every two years, is the percent of folks who either came to san francisco homeless, or became homeless while in san francisco. and then the length of time they've been here. so we can glean some information from that. i don't want to ballpark it because it can be a sensitive sort of issue. anywhere from 25 to 40%, san francisco -- came to san francisco while homeless but that's self-reported and that's a pretty wide band. >> supervisor wiener: i would

imagine there were people who were already homeless and came here and remained homeless. there are people came here wanting to make a life here and understimulated and became homeless. >> i think the homeward bound, which reunites folks with their families or someone who can take care of them in other cities, when you look at those numbers, and we're at 8,000 who have been reunited with friends or families since 2004 that suggests a lot of folks came here, you know -- and not unlike others. san francisco is a city of refuge for a lot of folks. poor, not poor, college grads, gay lesbian youth, immigrants. but we're not a nation state. we're not going to close our borders. we need to be responsible. but that data does suggest that folks are coming here and it's not working out for them which

is why we started the program when we did eight years ago. >> supervisor wiener: thank you. >> uh-huh. >> chair farrell: supervisor breed. >> supervisor breed: thank you. i just had a few questions about jobs now program, and wanted to know specifically what is happening to help deal with the transition of employment for jobs now. for example, people may take on the responsibility of someone, and the assistance to pay them through jobs now. but there comes a point where the jobs now support runs out, and then typically sometimes we've had situations where that person is laid off, and then they're collecting unemployment, or it just -- there's no transition or no link to a maybe long-term job opportunity in maybe another field or something to that effect. just wanted to know a little bit more about how the jobs program

is specifically connecting people to long-term job security. >> sure. so the goal of jobs now is to get someone immediately into employment and get income into their pocket. the secondary goal is to get someone who has a fairly -- typically a fairly limited work history or limited educational background, to get that experience. what we have found, and this is data from when we started the program in 2009, and we have a very large sample of over 5,000 placements that very often, in the private sector, once the subsidy ran out, if the employee was successful, the employer kept that employee on, over half. i'll get you the exact numbers, i don't remember. i think it was in the 60% but let's call it over half were retained. they retained a full time job, not on the city's dime anymore.

88% of employees placed said it added value to the company. you can take any job training or job placement program in the city, whether it's nonprofit run or city run and you will never find a 50% placement rate. it's a very, very high placement rate number for folks with multiple barriers to employment. so it shows this is an effective strategy. we have a very large public sector to jobs now. so this is a public service trainees in rec and park, dpw, hssa and other city departments. the placements tend to be six months, some can last up to a year. we have been working with dhr to allow those placements to count for mqs for city employment and met minimum qualifications. our staff is working with these clients. they're getting help with their

résume, with soft skills, interview skills, things like that, they're connected with us. so we encourage folks to apply for, and get on lists for city employment, and at hssa. we've been able to hire a lot and getting former public assistance recipients working as case worgers in our system. city employment is not the answer to long-term employment. even though we're a very large employer what we do want is for people to get those job skills. you mentioned folks who don't get jobs, and there are certainly a lot, about you what they have after their placement is hopefully a solid reference. they certainly have a solid -- now a recent work history. they are now engaged in the unemployment system so they're getting a benefit higher than what they get from the city and working to get a better job. so we're now engaged in a study, and i mentioned this last time i was here, with a national study with the department of human and

health services and a think tank around employment training programs. i think there's eight sites across the country on the effectiveness of subsidized employment as a development strategy. i'm hoping it will say it has by far the best outcomes. and sort of betting on it we're continuing to expand it, not only getting them a permanent job but paying them now and incentivizing them, and being them in the job market while being played. stand alone job training don't do that. >> supervisor breed: what categories would you put it in the private or public? >> the private i mentioned, the 50% plus stickiness was private. but we do have a large placement component for -- in the nonprofit sector as well.

it's just we found it's more difficult to keep individuals on. >> supervisor breed: do you think that your case management support, in terms of job training, job support, résume building, and that component, has gotten better over the years, especially since you somewhat inherited the program initially, and had to act quickly to get things going, and now, it's at a point of stability, it seems, and things seem to be getting better? >> i think our employees at hsa have really stepped up to the plate to adapt to this new model. we had a welfare caseworkers who became business account representatives, a liaison between the private sector and our department helping place folks. folks doing -- performing entirely new roles in context of subsidized employment and enjoying the work and enjoying the satisfaction of placing someone. we started this in 2009 it was a

horrible labor market. it was a stimulus act, families coming in on public assistance competing with jobs with folks who had 10 years of job history. so they were excited and they've adapted well. and i think are really doing great work. talk about the governor's proposal, what that would go towards would be to expand placement in terms of subsidy but also expand the number of our workers. we got to allow someone to continue to work with folks we can't have case loads of 50, 60, 70, 80 people. they can't provide good service. if we keep them lower we see nice outcomes for families and even better using funds that aren't city and county dollars but are state dollars. >> supervisor breed: just one more question about the cal fresh. is there a fraud division that helps to deal with issues of fraud around these particular benefits? is. >> yeah. hssa has an investigative

division that deals with welfare fraud, deals with internal employee fraud. we're required by the feds to have what they call quality control but part of quality control is not only benefits accuracy, computing the right amount that someone is eligible for but also to investigate welfare fraud, yeah. >> supervisor breed: thank you. >> chair farrell: thank you. colleagues, any other questions? okay. thank you very much, mr. rohr, for your time today. at this point, i'd like to open it up to public comment, if there are any members of the public who wish to comment on this item, please step forward. >> my name is vera hale. i'm a member of the advisory council to the department of aging. and every year, i come up here about cuts, and it's such a joy to be here and to be able to talk about what the needs of the people are, and what some of the

things we think are coming in the future. i want to mention three things. one is the difference between -- one difference between calworks and medi-cal. cal fresh -- not calworks, cal fresh, has no asset limit. and this means that people will be able to apply, regardless of whether they have excess money in the bank or not. medi-cal will still, unless the state changes it, have an asset limit of $2,000 for one person, and $3,000 for a couple. and that's going to make it harder to ever get everything going easily back and forth. but one of the things that we found, anne hinton held a hearing in hunters point and one of the things we found was that people were so concerned about having to pay a share of costs

for their medi-cal, and for the in-home supportive services, ihss. a lot of people have shared costs of $500. and they ask that we do something about restoring share of cost program. the county used to have one that would let people pay -- county would pay a portion. so if they had high represent or high medical -- rent or high medical expenses then they didn't have to pay the 900. the county doesn't break down the budget that way. so we wanted to restore that. and we still do. and i'm working with senior disability action on that. and we're interested and hopefully we'll bring something to you in the coming months. just one item, homeless seniors are not hopeless. and but they can't get in shelters because they move slowly, they don't want the top

bunk, simple things that elderly take for granted. but other makes it very difficult for them to get through the shelter system. so we've been trying some of us to make it easier so seniors -- the big problem is the rents at the sro. >> chair farrell: if i could ask you to rap up please. thank you very much. >> the sros have gotten too high. when we had a homeless program at north of market, senior services, 80% were placed permanently. but no more. because the rents are exorbitant. >> chair farrell: thank you very much. any other members of the public wish to comment? >> i'm teresa, i've been up here a couple of times. i work for hsa. i worked in the play room. i was under the classification of 3280. when they were bumped out, we were bumped out of our positions. we also had 9910s with their hiring now to be trained, and

they stayed in the play rooms, and four of us were bumped out of our positions. we had another classification that came, that they gave us. we applied for the jobs. but i, and another person were the only one that was called for those positions. i'm hearing that they're hiring these people, and bringing in 9910s, and here, i've been out of work for five years. and i understood the city and county of san francisco should, or should have tried to place me in another position, which they didn't even do that. so i'm just saying, i don't understand what all this -- they're saying they're trying to do, when i've been out of work, and i'm sure there's others. and the overload of -- i've been out into the offices for the union, and talked to the people that are working there. and they're saying they're overloaded, weigh overloaded.

they have stacks of people's folders on their desk they can't even get to. and lo the of them are saying they just can't handle it, why is this going on. i'm helping -- i'm not even getting paid what i'm doing. i'll wrap it up. i'm helping these people keep 245eur jobs and get had a they need for their jobs. but i don't understand why i wasn't hired back. thank you. >> chair farrell: thank you very much. any other members of the public wish to comment on this item? all right. seeing none, public comment is closed. colleagues again this is a first hearing for hsa to come forward so we can preview the budget for next year. thank you mr. rohr and ms. hinton and cfo for being here. if we could continue this item to the call of the chair. do so without opposition. so moved. mr. clerk, do we have any other items? >> the clerk: that completes the agenda. >> chair farrell: we are adjourned.